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Nurse Author Paints Honest Portrayal of the Profession

May 4, 2011 - Any nurse who has worked in a hospital knows that caring for patients involves much more than just attending to their physical needs.

Theresa Brown BSN, RN, OCN, left her job as a writing teacher to pursue a career as an oncology nurse and author. Photo courtesy of Erika Larsen.

There are a thousand things that don’t go according to the medical books, hospital rules or care plans: unexpected emergencies, difficult patients and families, obstinate doctors, undependable co-workers, supply shortages, mysterious infectious outbreaks, and staff shortages. Even unpredictable weather can call for make-do solutions, and more often than not, it’s up to nurses to make it all right.

Add to all of these unpredictable elements a nurse’s vulnerability, frustrations, introspections, insecurities, joys and sadnesses, and you’ve got the reasons that Theresa Brown, BSN, RN, OCN, wrote Critical Care: A New Nurse Faces Death, Life, and Everything in Between (published in 2010 by HarperOne).

In it, the oncology nurse chronicles her first post-graduation year at University of Pittsburgh Medical Center Shadyside. Most nurses won’t find it difficult to find themselves among the pages.

“What I like best about ‘Critical Care’ is how close it is to reality,” said Brown’s co-worker, Shannon Moore Riskey, BSN, RN, OCN. “I feel that it very accurately portrays any given day…on our oncology floor. There are events that just make your heart race and adrenaline pump, and reading the book made that happen.”

Just how Brown, a 46-year-old Pittsburgh resident, found nursing is a story in itself. She received her BSN from the University of Pittsburgh in 2007 after earning a Ph.D. in English and teaching writing at Tufts University for three years.

“People continue to ask why I abandoned my Ph.D…,” Brown writes, “but as I grew older, I realized that the job held little personal meaning… I went in search of work that felt more fulfilling, and to my surprise, I discovered bedside nursing. Becoming the nurse-who-writes-about-nursing was a great lesson in following my heart and having things work out better than I ever hoped.”

Brown is married, the mother of a 14-year-old boy and 12-year-old twin girls, and usually works two 12-hour shifts a week. She also writes a monthly essay for the New York Times’ “Well” blog on the life lessons of nursing. Her September 2008 essay in the Times, entitled “Perhaps Death is Proud; More Reason to Savor Life,” launched her writing career and is included in Best American Science Writing 2009 and Best American Medical Writing 2009. This and other essays can be found on Brown’s website.

“I wrote the book with a general audience in mind,” Brown said in a phone interview shortly after returning home from a speaking engagement at the University of Wisconsin. “I was hoping to get people interested in what nurses do. We usually get books from doctors, but this is our story and now it’s out there to be read.”

Real-life nursing situations and issues, including nurse-doctor relationships, patient advocacy and treatment plans are all featured prominently in Brown’s book.

The author paints life on the oncology ward with honesty and thoughtfulness and without apology. Her book and essays tackle some delicate subjects: prolonging life when the cost of doing so is a waste of resources, nurses who harass their own, coercing patients to take treatments they don’t really want, the utter exhaustion and futility nurses can experience, and even “poop.”

One of her longer chapters is a creative and poignant essay on that four-letter word. She manages to elicit sympathy for both patient and nurse, and even injects some gentle humor.

Brown also tackles the topic of physicians who don’t respect the nurse’s role.

“My favorite quality about Theresa is her ability to stand up for the profession,” Riskey said. “I have seen her approach physicians who criticize nurses and ask in a non-confronting manner why they act the way that they do towards nurses and explain to them that they are wrong. Theresa is also always fighting to be the patient advocate. I commend her for not backing down against even the toughest physicians.”

The feedback from doctors has been mostly positive, Brown said.

“In fact, one of our attending physicians said he bought it so he could see things from our point of view. Another doctor said this should be required reading for medical students.”

Brown wrestled with the act of writing about real people – patients, families, co-workers and other staff – especially because of privacy laws.

“Everyone except for my personal friends, everyone has a different name,” she explained. “Most of the time I changed their names and their [physical] descriptions. None of the portrayals were intended to be slamming. Overall, the book has been received positively. It was good to find out that the people I work with are open-minded and welcoming.”

As for her lay audience, Brown believes that there is a fascination with what nurses do “because we are so intimate with patients. We see people at their worst and we are the translator between the doctor and the patient and the patient and the family. We’re always rubbing up against both sides.”

“Theresa's book helped me to remember that yes, we experience some horrible things as oncology nurses,” co-worker Riskey said, “but we also experience beautiful things and develop some amazing relationships with people and patients that you would never normally experience.”